Cirrhosis: CT and MRI imaging evaluation

In this article, we present the computed tomographic and magnetic resonance imaging characteristics of the cirrhotic liver. We describe the altered liver morphology in different forms of viral, alcoholic, and autoimmune end-stage liver disease. We present the spectrum of imaging findings in portal hypertension, such as splenomegaly, ascites, and varices. We describe the patchy and lacelike patterns of fibrosis, along with the focal confluent form. The process of hepatocarcinogenesis is detailed, from regenerative to dysplastic nodules to overt hepatocellular carcinoma. Different types of nonneoplastic focal liver lesions occurring in the cirrhotic liver are discussed, including arterially enhancing nodules, hemangiomas, and peribiliary cysts. We show different conditions causing liver morphology changes that can mimic cirrhosis, such as congenital hepatic fibrosis, “pseudocirrhosis” due to breast metastases treated with chemotherapy, Budd-Chiari syndrome, sarcoidosis and carvenous transformation of the portal vein.